Safe air should be there for all of us to share

Air, water and food are the 3 basic essentials (in that order) to sustain human life. One can stay without water and food for long periods but not without oxygen laden clean air even for a few moments. So breathing fresh air is essential to let us live to eat and drink and be merry. While we have the wherewithal to monitor and control the quality of what we eat or drink by using boiled/filtered water and hygienic food for our individual use, we cannot carry with us our personal container of purified air to breathe. The air around us (whether good or bad) has to be necessarily shared with others. Yet the importance of keeping it clean for all of us seems to have taken a backseat.

As kids we learnt that unlike solids and liquids gases/air do not have any fixed shape or volume. Their molecules move very fast and they simply expand to fill the space available to them. This makes the germs of airborne diseases, (which include a wide range of bacterial and viral infections, like influenza, pneumonia, acute respiratory infections, tuberculosis) spread far and wide, making all of us vulnerable to them through shared use of the air we breathe. Overall acute respiratory infections kill some 4.5 million adults and children each year. Influenza affects 3-5 million people each year and causes an average of 250,000-500,000 deaths. Globally there are an estimated 156 million cases of pneumonia each year and it is the leading cause of death in children under 5 and killed 1.3 million of them in 2011. Then again, tuberculosis caused 1.4 million deaths in 2011.

Settings in which people share air –like crowded neighbourhoods, public transportation, public facilities, health clinics, work places and schools–are breeding grounds for airborne diseases. The risk is always greater where people with weak health, such as the aged or people with compromised immune systems, come into contact with people who are sick. So, in the interest of our own wellbeing (as well as of others) we have ensure that the air around us is safe for inhaling and not becomes life threatening.

Air pollution from tobacco smoke, biomass fuels and car emissions jointly contribute to the air quality and airborne infections. Diseases caused by direct/indirect exposure to tobacco smoke kill nearly 6 million people (including some 600,000 non-smokers exposed to second-hand smoke) each year and account for 1 in 10 of all deaths, making tobacco the single most preventable cause of death in the world today. The WHO Framework Convention on Tobacco Control states that there is "no safe level of exposure to tobacco smoke." Creating 100% smoke-free environments is the only way to protect people from the harmful effects of second-hand tobacco smoke.

And yet many of the smokers I interviewed cited solid fuels, automobiles' emissions and industrial effluents as the top culprits for polluting our atmosphere, and not tobacco smoke. But many non- smokers felt that people who smoke should realise the stupendous harm they are doing to themselves, to others and to the environment.

According to many youngsters I interviewed in India and abroad, urbanization and consumerism go hand-in-hand with deteriorating ambient air quality. They felt that reliance on fossil fuels by the manufacturing as well as car industry has contributed to air pollution and that governments need to invest in streamlining public transport to reduce the number of vehicles on the road and in new automobile technologies for hybrid and electric vehicles.

Engineer Amitabh Pande, who had been involved in consulting for implementation of Kyoto Protocol related systems in the Asia-pacific region, rues that, "India is at the bottom of a list of 132 countries when it comes to air quality. We Indians do not take environmental pollution seriously. Even as more and more countries ban the use of diesel cars for personal use, diesel car sales in India, are touching 1million per annum, occupying 75% market share in popular car category. Also not many people know that the second largest consumer of diesel in our country, after the transport sector, is the telecom sector (which does not even figure in the list of top ten in most other countries) primarily due to lack of a stable power supply system. Although India ranks third after US and China in Green House Gas emissions, I have found the lack of awareness of the Indian bureaucracy on this topic so sickening that I felt ashamed and embarrassed being an Indian back then."

Dr Anil Kapur, former Managing Director of the World Diabetes Foundation, agrees that, "A major source of pollution is the exhaust from motor vehicles, and use of household generators/pump sets. Here apart from smoke and particulate matter, carbon monoxide emission is a big problem. Carbon monoxide from the lungs is absorbed in the blood and combines with haemoglobin to form carboxyl haemoglobin which limits the oxygen carrying capacity of the blood. This can be particularly harmful to people with already existing heart problems. Carboxyl haemoglobin also causes greater propensity for blood clots."

“Smoking tobacco and burning firewood, coal, and cow-dung, within the confines of the house, are perhaps the biggest problems at the individual level and one of the main causes of respiratory problems amongst housewives. Burning of tyres, plastic, garbage, grass, and bagasse (sugar cane pulp) to keep warm during winters, especially in North India, is another problem. This causes the ubiquitous smog which results in spasms of the respiratory tract muscles. Smoke and toxic fumes inhibit the movement of the respiratory cilia – microscopic hair like substances that prevent particulate matter including bacteria from lodging in the respiratory tract—making way for the particulate matter to settle down in the respiratory tract and make it vulnerable to infections.”

Nearly 3 billion people, most living in low-income countries, rely on solid fuel for cooking and heating, air pollution from which directly caused 3.5 million premature deaths in 2010 and another half million through its contribution to outdoor air pollution.

Acute lower respiratory infections (ALRIs) in children, chronic obstructive pulmonary disorder and lung cancer in women exposed to coal smoke have been shown to have a strong association with solid fuel smoke. Nearly half of the deaths among children under 5 years old from ALRIs are due to particulate matter inhaled from indoor smoke from household solid fuels.

According to what Dr Chen-Yuan Chiang, Director, Department of Lung Health and Non-Communicable Diseases, International Union Against Tuberculosis and Lung Disease (The Union) said to Citizen News Service – CNS: "The major source of indoor air pollution comes from domestic use of solid fuels. Globally, about 50% of all households and 90% of rural households use solid fuels (coal and biomass) as the main domestic source of energy. About 50% of the world population is exposed to the harmful effects of these combustion products. Strategies to reduce indoor air pollution include making available alternate, cleaner types of fuel; improving access to better stoves used for cooking and heating; improving the quality of the ventilation used for the stoves and providing education for behaviour change."

Hara Mihalea, a renowned Public Health and Tuberculosis Consultant from Thailand, avers that unsafe and polluted air, along with contaminated drinking water, contributes significantly to the health and quality of life of people worldwide. She strongly feels that: ‘unsafe air not only has severe health consequences like pulmonary and respiratory problems even in children, but also financial consequences to communities, individuals and governments by way of loss of work days/income and money spent on health care. The grim consequences of polluted air and contaminated water have gone just too far and to address them we will have to address poverty and invest in building proper community infrastructure.’

Lucknow based environmentalist Prabha Chaturvedi also agrees that, "Unlike eating and drinking, breathing cannot be done in isolation because air cannot be had in units, and therefore, it has got to be of the same quality for all. In urban India, the increasing density of population along with the fast increase in the number of automobiles and factories is adding heavily to the increase of carbon dioxide in the air. Coupled with this is the denudation of the forest cover that results in the reduction of oxygen in the atmosphere. At the individual level we can take some positive steps to mitigate the problem—reduce the use of automobiles; reduce use of fossil fuels for cooking and heating; planting as many trees as possible. Also, open air exercises, morning walks and deep breathing should find a regular place in our daily routine to improve the quality of our health."

Banker Ashutosh Lal wants us all to make our environment green to increase oxygen levels by improving ventilation in homes to let in fresh air/light; maintaining gardens in our houses and in the neighbourhood--tray gardens when there is no outdoor space; using car pools; encouraging school going children to use cycles instead of pampering them with two wheelers; using cloth shopping bags to reduce litter; using more green energy sources such as solar cookers, geysers and solar batteries; reducing the use of wooden furniture-- if demand is reduced then tree cutting will be reduced; and above all not allowing anybody to smoke indoors.

Even as we wage a battle against junk food and cola drinks we should also collectively strive to put an end to the indiscriminate polluting of the life giving air that surrounds us. Use of appropriate technology and fuel as well as educating ourselves and others about what we can do to avoid air pollution and its hazards is very important. And instead of just being prescriptive, can we please begin the change we want to see? Clean air has to be there for all of us forever—there cannot be a copyright on it—so that we can inhale it safely and share it too with our fellow beings in our homes, schools, and work/ public places without any fear of getting sick through airborne diseases.

Shobha Shukla is the Managing Editor of Citizen News Service - CNS. She is a J2J Fellow of National Press Foundation (NPF) USA and received her editing training in Singapore. She has earlier worked with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also co-authored and edited publications on childhood TB, childhood pneumonia, Hepatitis C Virus and HIV, violence against women and girls, and MDR-TB. www.citizen-news.org

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